A document by Chenyang Zhang. Click on the document to view its contents.

Objectives: To develop new tools integrating host immune response and viral activity to predict Peg-IFNα therapy efficiency in nucleos(t)ide analogues (NUCs)-treated chronic hepatitis B (CHB) patients. Methods: This post-hoc study analyzed data from 758 CHB patients who completed 48 weeks of Peg-IFNα add-on therapy in a prospective study. Clinical and biochemical data were collected every 12 weeks and evaluated for their predictive value of HBsAg seroclearance and seroconversion. Results: Age, qHBsAg, and ALT levels at Week 12 were associated with both HBsAg seroclearance and seroconversion. The ASAP-12 score, defined as the ALT to qHBsAg and age proportion at Week 12, demonstrated strong discrimination for both endpoints (AUROCs: 0.802 [cut-off 0.07] and 0.787 [cut-off 0.12], respectively; p<0.05). Patients with scores above the respective cut-offs had significantly higher cumulative probabilities of HBsAg seroclearance (63.4% vs. 17.8%, Log-rank test p<0.001) and seroconversion (47.3% vs. 11.0%, Log-rank test p<0.001). Higher ASAP-12 scores ( β=0.206, p=0.006) also independently correlated with elevated Week 48 HBsAb levels. Conclusions: The ASAP-12 score is an effective tool for predicting both HBsAg seroclearance and seroconversion at Week 48 of Peg-IFNα add-on therapy in NUCs-experienced CHB patients, enabling personalized therapeutic decisions.

Closely related species may produce hybrids, and these hybrids often display intermediate traits that can influence fitness and reproductive isolation. In this study, we examine Ambystoma barbouri and Ambystoma texanum, two sister salamander species that breed in contrasting aquatic habitats with differing levels of ultraviolet radiation (UVR) exposure. Although these species can hybridize, it remains unclear whether hybrid pigmentation responses to UVR confer an advantage, a disadvantage, or are simply intermediate between parental forms. Pigmentation in salamanders is regulated by chromatophores, melanophores and xanthophores, which help mitigate UVR-induced damage. Given previous knowledge on the species, habitats, and behaviors, we hypothesized that: (1) A. barbouri would show stronger UVR-induced pigmentation (i.e., greater darkening) than A. texanum, due to its exposure to clearer, shallower streams; (2) hybrids would exhibit intermediate responses; and (3) xanthophore coverage would remain stable or decrease under UVR as melanophores expand. To test these hypotheses, we conducted a fully factorial breeding experiment using pure and reciprocal hybrid crosses, exposing larvae to four UVR durations (0, 1, 4, and 12 hours). We quantified skin darkness and chromatophore-specific pigmentation using standardized digital image analysis, Bayesian beta regression, and Bayesian compositional regression. Our results supported all three hypotheses. A. barbouri showed greater darkening under UVR exposure than A. texanum, and hybrids exhibited intermediate responses, but with a greater similarity toward their maternal phenotype. Xanthophore coverage remained stable or declined with increasing UVR exposure, evidencing that their main purpose is different from UVR protection. These findings raise the possibility that hybrids could experience reduced performance if intermediate pigmentation is suboptimal, but that maternal effects may offset some of these disadvantages.

Managing Antidepressant-Induced Hyperhidrosis with Vitamin E: A Non-Pharmacologic ApproachSaad Nazir, MD¹, Mahnoor Azmat, MD¹, Neha Prathivadi¹, Divyaraj Bavishi, MD¹, Yasin Ibrahim, MD²¹Texas Tech University Health Sciences Center, Department of Psychiatry, Lubbock, TX, USA ²University of Texas at Tyler, Tyler, TX, USACorresponding Author:Dr. Saad NazirEmail: saadkolachi@hotmail.comUnited States3601 4th Street, Lubbock, TX 79430Texas Tech University Health Sciences CenterDepartment of Psychiatry

A document by Gebreegziabher Hailay. Click on the document to view its contents.

Background: To investigate the role of social determinants of health (SDoH) in neurocognitive functioning among children with acute lymphoblastic leukemia (ALL), central nervous system (CNS) tumors, and sickle cell disease (SCD). Procedure: Fifty-eight child-caregiver dyads participated. SDoH included components of socioeconomic status (SES; including family income, caregiver education, and insurance type), race/ethnicity, caregiver marital status, and neighborhood-level deprivation. Neurocognitive functioning was measured using the NIH Toolbox Cognition Battery (NIHTB-CB). Results: Despite expected differences in race/ethnicity (χ 2 (4, n = 51) = 46.1, p < 0.001), there were no differences in SDoH between the three diagnosis groups. Bivariate analyses found a significant association between family income and working memory ( r = 0.31, p < 0.05), processing speed ( r = 0.29, p < 0.05), and fluid cognition composite scores ( r = 0.29, p < 0.05). No other SDoH were associated with neurocognitive functioning. Family income remained significantly associated with performance on working memory ( β = 0.35, p < 0.05), processing speed ( β = 0.33, p < 0.05), and fluid cognition composite scores ( β = 0.29, p < 0.05) after controlling for diagnosis, age, and sex. Conclusions: Lower family income emerged as an important element of SES associated with poorer neurocognitive functioning in children treated for cancer and blood disorders. Further research is needed to determine how family income alters neurocognitive functioning, whether by altering the timing of emergence or magnitude of deficits. Future studies should investigate mechanisms linking low income to neurocognitive performance to inform interventions to bolster neurocognitive development.

Age-related increase in anaphylaxis severity is associated with enhanced sensitivity to allergic mediatorsTo the Editor,Anaphylactic shock is the most severe outcome of an immunoglobulin E (IgE)-mediated allergy. This potentially life-threatening reaction with multi-organ involvement is characterized by a rapid hypersensitivity response to allergen exposure. Despite the well-documented general decline in immune cell function associated with aging, referred to as immunosenescence (1), older adults often experience more severe allergic reactions as compared to younger patients (2,3). Given the rising incidence of severe anaphylaxis (4) in conjunction with the rapidly growing elderly population (5), we sought to investigate the underlying mechanisms contributing to this age-related increase in allergy severity.First, we investigated whether the age-related increase in anaphylaxis severity that has been observed in humans is reproducible in mice. For this purpose, we passively sensitized young and aged C57BL/6 wild type (WT) mice intravenously with 2,4,6-trinitrophenyl (TNP)-specific IgE (clone: MEB-38), followed by intraperitoneal challenge with TNP-ovalbumin conjugate (TNP-OVA) on the next day (Figure 1A). Indeed, aged mice exhibited significantly stronger anaphylactic responses, evidenced by greater loss in body temperature (Figure 1B) and a larger area under the hypothermia curve (AUC) (Figure 1C). To our surprise, serum levels of allergic effector cell-related mediators including histamine and mMCP-1 showed no significant differences between age groups (Figure 1D and E).To further confirm these findings, we used humanized FcεRIα (huFcεRIα) mice sensitized with equal amounts of 4-hydroxy-3-iodo-5-nitrophenylacetyl (NIP)-specific human IgE (clone: JW8) followed by intraperitoneal challenge with NIP-bovine serum albumin conjugate (NIP-BSA) on the next day (Figure 1F). The pattern of exaggerated anaphylaxis in aged mice was consistent, with increased body core temperature loss and AUC values (Figure 1G and H). Further analysis of allergic effector cell mediator levels (histamine and mMCP-1) again showed no age-related differences (Figure 1I and J).To explore potential contributors to increased anaphylaxis severity in aged mice, we additionally quantified basophil cell numbers and the amount of NIP-BSA-specific IgE on blood basophils before antigen challenge. Interestingly, aged mice showed neither increased blood basophil counts nor higher IgE levels on these cells (Figure 1K and L). In contrast, the amount of NIP-BSA-specific IgE on blood basophils was significantly lower in aged compared to young mice (Figure 1L), whileex vivo sensitization with exogenous IgE exhibited comparable IgE loading on blood basophils from young and aged mice, indicating that the reduced in vivo IgE binding was not due to differences in available high-affinity IgE receptor levels on these cells (Figure 1M).To further evaluate potential age-related changes in allergic effector cell behavior, we cultured bone marrow-derived mast cells (BMMCs) from young and aged WT and huFcεRIα mice and assessed their degranulation capacity in vitro . Aged BMMCs sensitized with JW8-IgE, Sus11-IgE or MEB38-IgE and challenged either in an antigen-dependent (NIP-BSA/TNP-OVA) or -independent (anti-IgE antibody Le27) way unexpectedly showed reduced activation levels as compared to young BMMCs as measured by surface levels of the degranulation marker CD107a (Figure 2A and B). Overall, these data strongly indicate that neither allergic effector cell expansion or function nor increased IgE-binding capacity appears to drive enhanced anaphylaxis severity in aged mice.Finally, to test the hypothesis whether aging might lead to an increased sensitivity to allergic mediators, we bypassed allergic effector cell activation and directly administered a fixed amount of exogenous histamine to young and aged WT mice (Figure 2C). Strikingly, aged mice showed significantly stronger anaphylactic responses (Figure 2D and E) at equal serum histamine levels (Figure 2F) indicating increased physiological sensitivity to allergic effector cell-derived mediators.In summary, our findings reveal that age-related increase in anaphylaxis severity is independent of altered effector cell activity or mediator release but is associated with an enhanced physiological responsiveness to allergic mediators such as histamine.

Urban transportation systems are essential in fulfilling the requirements of residents while guaranteeing the normal functioning of cities. These systems encompass various modes of transportation, infrastructure, and services that enable people to move within and between urban areas. However, the challenges posed by escalating urbanization, particularly the growing menace of traffic congestion, underscore the pressing need for effective solutions. We propose an Adaptive and Dynamic Spatio-Temporal Network (ADSTN) as an innovative solution to the complexities associated with traffic congestion. The identified shortcomings in existing models, such as their limitations in capturing authentic spatial dependencies, insufficient understanding of the heterogeneous relationship between the temporal and spatial domains, and the oversight of local trend information, motivate the development of ADSTN. The model integrates three key components: a learnable adaptive attention module, a local temporal self-attention block, and a spatio-temporal dynamic graph convolution block. ADSTN stands out for its outstanding performance in handling local spatio-temporal dependencies, periodicity, and dynamics within traffic flow forecasting. Evaluation on three public real-world datasets underscores competitive achievements of ADSTN contrasted to state-of-the-art models, all while maintaining computational efficiency.

Phonon engineering, as a commonly used strategy to achieve high thermoelectric performance, typically requires heavy doping to achieve the largely suppressed thermal conductivity. In this work of the Hf-doped Zr3Ni3Sb4 Zintl, we discovered two unconventional mechanisms, namely avoided crossing and phonon softening, which enable a significant reduction in lattice thermal conductivity with only a small amount of Hf doping. DFT calculations reveal that the significant phonon-rattler scattering induced by the heavy element Hf doping is the physical origin of the occurrence of avoided crossing and phonon softening, which effectively suppress the group velocity at certain frequencies, shorten the phonon lifetime, and significantly increase phonon anharmonicity. Furthermore, Zr2.75Hf0.25Ni3Sb3.95Te0.05 alloy is experintally identified as the optimal composition. A small amount of Hf drastically lowers the lattice thermal conductivity and marginally decreases the electrical conductivity, leading to the increased average ZT value by 21%. These results highlight the application potential of Zr3Ni3Sb4-based alloys during the medium to high temperature range. Meanwhile, this study provides a new and unconventional phonon mechanism for isoelectronic alloying, which can be applicable to other thermal management aspects.

Background Hospital-acquired Respiratory Syncytial Virus (HA-RSV) infections pose a substantial risk to hospitalised children, previously described as composing a fifth of RSV-related deaths worldwide. Despite this, the epidemiology of HA-RSV remains undercharacterised, with limited meta-analytical evidence quantifying its incidence and mortality. Methods We conducted a systematic review and meta-analysis of English language papers published between January 1975 and March 2024 searching Embase, MEDLINE, and CABI Global Health. We included studies with primary data on paediatric HA-RSV cases among either all patients, patients with RSV, or patients with healthcare-acquired infections (HAIs). Outbreak reports were excluded for the purposes of this analysis. Using random-effects meta-analyses, we synthesised the HA-RSV incidence rate (IR) and mortality rate (MR) among patient groups, reported as cases and deaths per 1000 person-years respectively. HA-RSV cumulative incidence (CI) and case-fatality rate (CFR) are also reported as percentages. The JBI critical appraisal tool was used for quality assessment. Results 27 studies from 11 countries were included. The pooled HA-RSV IR among all paediatric patients was 10.86 cases (95% confidence interval: 3.83 – 17.89) per 1000 person-years. The mortality rate was 12.53 (6.20–18.86) deaths per 1,000 person-years, and the pooled CFR was 14.73% (4.77%–24.69%). HA-RSV comprised 15.57% of RSV hospitalisations and 22.48% of all HAIs. Conclusions HA-RSV is a serious and under-recognised cause of morbidity and mortality in hospitalised paediatric patients, with significantly higher mortality than community-acquired RSV. These findings underscore the need for strengthened infection control, standardised diagnostic criteria, and targeted preventative strategies to mitigate its impact globally.

Drylands, supporting significant global biodiversity, exhibit abrupt, non-linear responses to increasing aridity with drastic declines after threshold crossing. While plant and soil responses are documented, impacts on other organisms remain unclear. Animals possess movement capacities and adaptations that may enhance aridity resistance but increase sensitivity to anthropogenic disturbances. We investigated how aridity affects taxonomic and trophic richness across multiple organisms (bacteria to mammals) in dryland ecoregions. All groups showed threshold responses to aridity, occurring sequentially with varying biodiversity losses (19-54.3% depending on trophic group) after crossing thresholds. Responses were most widespread in hyper-arid and arid regions, primarily affecting herbivores and detritivores in semi-arid areas, and were exacerbated by human disturbance and land-use change. However, primary productivity and richness of primary producers and prior trophic levels partially buffered these declines. Biodiversity loss with increasing aridity scales across multiple dryland organisms and trophic levels but can be mitigated through plant biodiversity conservation and anthropogenic pressures.

A document by Ahmad Alikhani. Click on the document to view its contents.

A document by Muhammad Hassaan Javaid. Click on the document to view its contents.

Single-Retainer Lithium Disilicate Glass Ceramic Fixed Dental Prosthesis for Replacement of a Mandibular Central Incisor Using CAD/CAM Technology and Virtual Articulator: A Case Report

A document by Aishwarya Holi. Click on the document to view its contents.

Pancreatic Pseudocyst Masquerading as Massive Right Pleural Effusion: A case of Clinical and Radiological Findings

In this paper, we propose a coupled system that describes the interaction between the Relativistic-Cucker-Smale model and the incompressible Navier-Stokes equations by means of a drag force and establish a theory of global existence, as well as the time-asymptotic behavior of the proposed model in T 3 . It is shown that the coupled system exhibits an exponential alignment under some specific assumptions, and that weak solutions exist globally for general initial data.

Objective: To evaluate the feasibility and reproducibility of two field tests for upper limbs (Unsupported Upper Limb Exercise Test - UULEX and Six-Minute Pegboard Ring Test - 6PBRT) in children and adolescents. Methods: Feasibility study. Fifteen healthy volunteers aged 6 to 17 years were included. Lung function was performed, followed by: Cardiopulmonary Exercise Test (CPET), UULEX and 6PBRT. The CPET was performed on an upper limb ergometer using an incremental protocol. UULEX: seated arm-raising while holding weighted bars (0.25–2.0 kg) through graded heights; outcome = test duration (min). 6PBRT: seated transfer of rings between lower and upper pegs for 6 min; outcome = total rings moved. For all tests, peak oxygen consumption (VO 2peak) was also an outcome. The UULEX and 6PBRT were performed twice each (test and retest), 30-minute apart. Feasibility criteria were (i) no major procedural difficulties and (ii) < 15 % of participants reaching ceiling or floor thresholds. Results: 15 volunteers, median age 11 [9-15] years-old, and normal lung function (> 80% predicted). No volunteers considered the tests challenging. UULEX: Two volunteers (13%) reached the celling (13 min), none reached the floor (1 min). 6MPRT: no ceiling cases, one volunteer (6%) stopped above the floor (206 rings). The UULEX test vs. retest was 9.5 [8.0 - 12.0] min vs. 9.4 [8.2-12.0] min (p = 0.13) (ICC = 0.93 (0.78–0.97), p < 0.001). The 6PBRT test vs. retest was 299 [258-373] rings vs. 340 [244-387] rings (p = 0.05) (ICC = 0.97 (0.91–0.99), p < 0.001). Standard errors were < 10 % of their respective medians. The CPET elicited higher VO 2peak (22.8 [19.4–26] mL/kg•min -1) compared to UULEX (11.8 [10.2-13.6] mL/kg) or 6PBRT (11.6 [9–12] mL/kg) (p = 0.001). Conclusion: Both UULEX and 6PBRT are feasible and reproducible field tests for upper limbs in children and adolescents, providing practical options for upper-limb functional assessment.